| Doctor Name: | MICHAEL C. MARTIN |
| NPI Number: | 1023415528 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | PA9109166 |
| Business Practice Address: | 145 Eagles Walk Suite A Stockbridge, GA - 302817340 |
| Business Phone Number: | 7709140116 |
| Business Fax Number: | 7709147703 |
| Mailing Address: | 145 Eagles Walk, Suite A STOCKBRIDGE |
| State: | GA |
| Postal Code: | 302817340 |
| Phone Number: | 7709140116 |
| Fax Number: | 7709147703 |
| NPI Enumeration Date: | 11/26/2014 |
| NPI Last Update Date: | 04/07/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | PA9109166 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | FL |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |